The Irish Medical Organisation (IMO) has again warned the Government of potential legal action if it does not agree to negotiate on all aspects of the contract, including the fee arrangements, for doctors providing the planned free GP care services for children under six years.

In a letter to Minister for Health James Reilly and Minister of State Alex White, the IMO said “negotiation which addresses the scope and content of the contract without addressing what GPs are to be paid for delivering the services is impossible and meaningless”.

Mr White told the IMO last week the Government would negotiate “meaningfully” with it on all aspects of the proposed contract with the exception of fees. The setting of fees for the service “must remain a matter for the Minister for Health”.

In the letter sent in reply to Mr White by the IMO on Friday, the organisation’s chief operating officer Susan Clyne said: “As you have recognised the IMO is a registered trade union holding a negotiation licence and it is the only body representing doctors to hold such a licence. Accordingly, please confirm whether you intend to negotiate solely with the IMO or whether the contract negotiations are open to other parties.

“As a registered trade union holding a negotiation licence, the IMO is entitled to negotiate with the department and the HSE in respect of all aspects of the proposed contract.

“It is not apparent to the IMO how the process of discussing what GPs are to do under the new contract, and what they are paid for what they are to do, can be severed. One necessarily informs and conditions the other.”

The IMO said it did not want to engage in litigation but would have no option but to do so “in default of a satisfactory response”.

Mr White was heckled as he spoke in Clonmel on Saturday about the draft contract for GPs but said he would engage with GPs before any policies were finalised. He was addressing a conference on primary care organised by the Irish College of General Practitioners, whose medical director, Dr Margaret O’Riordan, said the free GP scheme was “not deliverable with current available manpower”.